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Behind Closed Doors; Lunatic Asylum Keepers, 1800–60
* Institute of Advanced Research in the Humanities, The University of Birmingham, PO Box 363, Birmingham B15 2TT.
SUMMARY: This article considers the nature of staffing in lunatic asylums, during a period in which there was a steady expansion of institutional provision for the insane. Previous published work on the development of asylum provision has tended to overlook the keepers or attendants, whose role was crucial in determining the quality of care and treatment of patients.
Keepers were generally recruited from the local labouring classes. It was unusual for staff to have had previous relevant experience. Height and size were often seen as the chief qualifications. Pay in the asylums was low, though compensated for by the inclusion of full board and lodging. Staffing levels were inadequate and supervision poor. The working and private lives of keepers were constrained by strict rules and regulations.
The relationship between keeper and patient was an unequal one. The keeper was in a position to exercise considerable power, particularly in those asylums which made extensive use of the instruments of mechanical restraint or of punitive treatment methods. In the asylums of the post-1845 reform era, control was expressed more through the asylum structure and management system than overt physical domina
Keywords: England; asylum; psychiatric nursing; social control; patients; mental health reform
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